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Cholesterol, Lipids, and the Role of Exercise - The Apeiron Life Perspective


What is it:

Cholesterol is a waxy, fat-like substance produced by the body and found in all the body's cells. Cholesterol has many essential roles, such as making hormones estrogen and testosterone, vitamin D, and bile acids that aid digestion. It is also a component of cell membranes and plays a role in maintaining their integrity and fluidity.

There are two main types of cholesterol: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL, often referred to as "bad cholesterol," is the type of cholesterol that makes up the plaque that clogs arteries and tends to increase the risk of atherosclerosis or hardening and narrowing of the arteries and cardiovascular disease. The ideal levels of LDL should be less than 100 mg/dL. HDL cholesterol, on the other hand, helps remove some LDL from the body and is usually referred to as "good cholesterol." You should aim to keep your HDL levels around 60 mg/dL. Dyslipidemia is the imbalance of cholesterol and other lipids, such as triglycerides and lipoproteins.


Genetic factors can contribute to high cholesterol; about one in 250 have familial hypercholesterolemia, an inherited condition with higher cholesterol levels than normal from birth. Many animal foods, such as egg yolks and shellfish, contain cholesterol, but recognizing that dietary cholesterol has little effect on blood cholesterol is essential.


Cholesterol is a crucial structural component that forms every cell membrane in our bodies. We need it to create Vitamin D, bile salts, and many other hormones, yet it is a misunderstood feature. So what is the difference between dietary and blood cholesterol and its influence on our health:

  • Dietary cholesterol is found in foods such as eggs, seafood, and liver. However, this type of cholesterol is not the same as the cholesterol in our blood because our body has checkpoints for absorption. Our body is very clever at checking whether we have enough from our diet and only allowing a certain amount to be absorbed. The cholesterol you eat is not the same as your blood cholesterol.

  • Blood (or serum) cholesterol increases when foods that contain saturated fat, such as red meat, cheese, and butter, are consumed. But ~75% (Silva, 2013) of the cholesterol in our blood is made and recycled by our body, not absorbed from our food.

Check out our blog post on Dietary versus Blood to better understand optimal blood cholesterol levels.


Although the typical treatment for high cholesterol and dyslipidemia is medication, exercise has been shown to have unique benefits and can be particularly important in improving lipid profiles. Physicians are now encouraging aerobic exercise in addition to medication and dietary changes to combat dyslipidemia.



How can exercise improve cholesterol levels:

  • Increase HDL cholesterol and lower LDL cholesterol

  • Improve lipid metabolism

  • Weight management

  • Better insulin sensitivity

  • Reduce inflammation


What the science says:

A heart-healthy diet is essential for overall health and is often the first step for people with high cholesterol. However, exercise has also shown a substantial impact on controlling lipid levels. A study published in the Journal of the American College of Cardiology found that exercise alone, without dietary changes, improved lipid profiles, including reductions in total cholesterol, LDL cholesterol, and triglycerides. Another study published in the American Journal of Cardiology showed that exercise training significantly improved HDL cholesterol levels compared to dietary changes alone.


Exercise has many ways of improving your metabolic health. It can enhance the body's ability to metabolize and utilize fats for energy. One clinical trial found that exercise reduced the non-fasting triglyceride response to a high-fat diet in individuals with metabolic syndrome. High triglyceride levels are associated with an increased risk of heart disease. Regular exercise is also a powerful tool for managing weight. Excess weight, especially abdominal fat, is linked to high cholesterol and cardiovascular disease. Exercise's effect on insulin sensitivity is highly beneficial in preventing metabolic disease. Insulin resistance, a condition in which the body's cells become less responsive to insulin, is associated with dyslipidemia and an increased risk of cardiovascular disease.


Regular exercise is a powerful tool in reducing chronic, prolonged inflammation, a significant risk factor for morbidity and mortality. Chronic inflammation is associated with the development and progression of atherosclerosis, a condition characterized by plaque buildup in the arteries. Recent studies have shown that combined exercise can have a greater anti-inflammatory effect than aerobic or resistance training alone.


Aerobic exercise may be the most efficient activity for lowering cholesterol. Exercise time, volume, and intensity all affect blood lipids. HIIT (high-intensity interval training) might have additional advantages in treating those with elevated LDL, triglyceride levels, and metabolic syndrome. A randomized control trial conducted on overweight and obese adults found that HIIT significantly reduced total cholesterol, LDL cholesterol, and triglyceride levels while increasing HDL cholesterol levels. Another study on sedentary men with metabolic syndrome showed that HIIT resulted in significant reductions in total cholesterol, LDL cholesterol, and triglycerides, as well as an increase in HDL cholesterol.


The evidence is less straightforward regarding strength training and its effect on lowering cholesterol. Some studies show little effect, whereas others show a more significant impact. There also seems to be a difference based on the intensity of training. Most studies seem to conclude that the increased volume of movement via increased numbers of sets and/or repetitions has a greater impact on the lipid profile than increased intensity. This means the best resistance training method for lowering cholesterol and lipid levels is probably low- to moderate-intensity style resistance training.



Our take:

The role of exercise in controlling cholesterol can be significant. Together with dietary changes such as lowering the intake of saturated fats and sugar, they are the best tools to combat high cholesterol and dyslipidemia. The duration of exercise required to lower cholesterol levels can vary depending on various factors, including the individual's baseline cholesterol levels, overall health, and exercise intensity. Generally, at least 150 minutes of moderate or 75 minutes of vigorous exercise per week can help improve cholesterol levels. But it's important to acknowledge that consistency and regularity of training are more important than volume, meaning it's better to spread the exercise sessions throughout the week. Suppose you're currently not exercising or are unable to increase your volume because of health or other reasons. In that case, it is good to remember that any amount of exercise is better than being sedentary.


If you have been exercising for a while but still struggling with elevated cholesterol and lipid levels, it might be a good idea to experiment with HIIT training if it is appropriate for you. The Apeiron Life Personal Trainers are your best resources to ensure you increase your volume and/or intensity effectively and safely.



Will this benefit you?

Regardless of whether your lipid profile is at the optimal level or needs improvement, exercise can help you reach your health goals and decrease your risk of cardiovascular disease.


If you’re still interested, here’s what to keep an eye on:

Although exercising has no known negative consequences to lower cholesterol, individual responses will vary. Some people may experience a more positive impact on their cholesterol and lipids levels than others. However, exercise is considered beneficial for cardiovascular health and quality of life in general. If you’re currently on statins to treat high cholesterol, talk to your physician first to ensure you can start an exercise program along with your medications. Never stop taking medications before consulting with your doctor.



References and additional reading:

HIIT training and lipid levels: https://pubmed.ncbi.nlm.nih.gov/18606913/

HIIT in treating overweight/diabetic men: https://pubmed.ncbi.nlm.nih.gov/20153487/

Aerobic exercise and lipids after high-fat meal: https://pubmed.ncbi.nlm.nih.gov/18981938/

Weight loss, cholesterol and cardiovascular risk: https://pubmed.ncbi.nlm.nih.gov/27528523/

Different training modalities and lipid profiles: https://pubmed.ncbi.nlm.nih.gov/10985600/

Aerobic vs anaerobic training and lipid profiles: https://pubmed.ncbi.nlm.nih.gov/8244606/

Aerobic and resistance training and cholesterol: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3906547/

Combined training and inflammation:


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